OrganizationActive
Logan General Hospital LLC
NPI 1720032105 · Podiatrist · Logan, WV
Provider details
- NPI number
- 1720032105
- Entity type
- Organization
- Primary specialty
- PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Johnetta Traylor, Ao(502) 596-6063
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
- Anesthesiology Physician207L00000X
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Body Imaging Physician2085B0100X
Allopathic & Osteopathic Physicians
- General Practice Physician208D00000X
Allopathic & Osteopathic Physicians
Practice location
20 Hospital Dr
Logan, WV 25601-3452
Phone: (304) 831-1101
Fax: (304) 831-1958
Approximate (ZIP-level) locationGet directions
Mailing address
680 S 4th St
Louisville, KY 40202-2407
Registry dates
- Enumerated
- 2006-05-20
- Last updated
- 2026-03-06
- Certified
- 2026-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.